Lyme Disease

Clinic A/P, adults, Clinic A/P, Peds, Hospital A/P, Adults, Hospital A/P, Peds

Background
Is the most common vector-borne infection in the United States and Europe.

  • NE USA
  • Campers/hikers
  • Ixodes tick harbors Borrelia burgdorferi

Stages:

  • Stage I: erythema migrans (pathognomonic), viral-like syndrome
  • Stage II: arthritis, myocarditis, bilateral Bell’s palsy
  • Stage III: chronic arthritis, chronic encephalopathy

Treatment
-Prophylaxis in asymptomatic patients after a known tick bite. Only recommended for tick attachment longer than 36 hours, removal of an engorged tick, or of unknown duration. A single dose of Doxycycline 200 mg x 1. Prophylaxis must be given within 72 hours of after removal of a deer tick.
Stage 1:
Stage 2: Doxycycline for 14 days + Corticosteroids (facial nerve palsy)
Stage 3:
-If CNS/cardiac involvement: IV ceftriaxone
-If Pregnant/children Rx: amoxicillin

 

 

Further Reading / Reference

Treatment of Lyme disease. Med Lett Drugs Ther 2016;58(1494):57-  58.

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